Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.37 / $162.50 / $313.80	Facility		$64.37	$162.50	$313.80
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.99 / $9.86 / $21.68	Facility	26	$8.99	$9.86	$21.68
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.44 / $45.20 / $359.76	Facility	TC	$19.44	$45.20	$359.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.53 / $30.04 / $64.37	Professional		$25.53	$30.04	$64.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.57 / $10.00 / $21.75	Professional	26	$9.57	$10.00	$21.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.96 / $20.05 / $42.70	Professional	TC	$17.96	$20.05	$42.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.07 / $23.83 / $66.31	Professional		$23.07	$23.83	$66.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.66 / $9.57 / $23.93	Professional	26	$7.66	$9.57	$23.93
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $13.86 / $19.48 / $30.26	Professional	TC	$13.86	$19.48	$30.26
BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.76 / $95.76 / $105.34	Facility		$95.76	$95.76	$105.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.00 / $52.00 / $52.00	Professional		$52.00	$52.00	$52.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.09 / $68.78 / $78.61	Facility		$23.09	$68.78	$78.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.58 / $41.42 / $57.32	Professional		$25.58	$41.42	$57.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.90 / $16.04 / $21.52	Professional	26	$8.90	$16.04	$21.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.92 / $26.23 / $35.54	Professional	TC	$16.92	$26.23	$35.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $8.72 / $32.34 / $32.34	Professional		$8.72	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $23.47 / $35.52 / $60.03	Professional		$23.47	$35.52	$60.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.60 / $12.36 / $23.85	Professional	26	$8.60	$12.36	$23.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.38 / $22.80 / $40.72	Professional	TC	$14.38	$22.80	$40.72